Premium
A CASE WITH DIFFUSE NARROWING OF THE MAIN PANCREATIC DUCT SUCCESSFULLY TREATED BY STEROID THERAPY
Author(s) -
Takizawa Hideaki,
Suzuki Yasufumi,
Aoyagi Yutaka,
Asakura Hitoshi
Publication year - 2000
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1046/j.1443-1661.2000.00030.x
Subject(s) - medicine , autoimmune pancreatitis , pancreatic duct , pancreas , pancreatitis , abdomen , radiology , gastroenterology , prednisolone , abdominal ultrasonography , ultrasonography
We report a case of chronic pancreatitis with diffuse narrowing of the main pancreatic duct. A 66‐year‐old man complained of an abdominal mass at the upper abdominal region. Increased serum levels of γ‐globulin, immunoglobulin G and elastase‐1, and disturbed pancreatic function with low urinary excretion of bentiromide were demonstrated. The abdominal ultrasonography and computed tomography of the abdomen revealed diffuse enlargement of the entire pancreas without a localized mass. Endoscopic retrograde pancreatography showed diffuse and irregular narrowing of the main pancreatic duct from the head to the tail of the pancreas. Based on these characteristic findings, the patient was strongly suggestive of having so‐called ‘autoimmune pancreatitis’, and was treated with steroids. Administration of prednisolone had reduced the size of the pancreas. Moreover, follow‐up endoscopic retrograde pancreatography demonstrated an improvement of the narrowing of the main pancreatic duct. Dramatic improvement by steroid therapy suggested that the etiology of this disease seemed to be related to autoimmunity.